Crall H D, Mattison D R
Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock.
Gynecol Obstet Invest. 1991;31(1):17-22. doi: 10.1159/000293094.
Despite common use in obstetrics for almost 50 years, there is still disagreement concerning optimal clinical protocols for the use of oxytocin. This disagreement arises in part from inadequate data on oxytocin pharmacokinetics and pharmacodynamics. This report evaluates the uterine response to fixed doses of oxytocin (1-3 mIU/min) over long infusion times (up to 120 min) in 10 patients with secondary arrest of dilatation. The uterine activity increased from 132 +/- 61 Alexandria units during the control period to 199 +/- 64 Alexandria units at an infusion rate of 1 mIU/min. Increasing the infusion rate to 2 mIU/min increased the uterine activity to 240 +/- 64 Alexandria units. The uterine activity increased until a steady state was achieved between 40 and 70 min after the initiation of infusion. Continuing the infusion at a fixed rate for more than 90 min appears to result in a decreasing uterine activity. Patients requiring oxytocin for augmentation of labor developed adequate uterine activity with dose rates of 1-3 mIU/min. Clinical protocols for oxytocin augmentation with an interval of 40-60 min between increases in the dosing seem reasonable based on these pharmacodynamic data.
尽管缩宫素在产科已广泛应用近50年，但关于其最佳临床应用方案仍存在分歧。这种分歧部分源于缩宫素药代动力学和药效学数据不足。本报告评估了10例继发性扩张停滞患者在长时间输注（长达120分钟）固定剂量缩宫素（1 - 3 mIU/分钟）时的子宫反应。在对照期，子宫活动度为132±61亚历山德里亚单位，输注速率为1 mIU/分钟时增加至199±64亚历山德里亚单位。将输注速率增至2 mIU/分钟时，子宫活动度增加至240±64亚历山德里亚单位。子宫活动度持续增加，直至输注开始后40至70分钟达到稳定状态。以固定速率持续输注超过90分钟似乎会导致子宫活动度下降。需要缩宫素加强宫缩的患者在1 - 3 mIU/分钟的剂量率下可产生足够的子宫活动度。基于这些药效学数据，缩宫素加强宫缩的临床方案，每次增加剂量间隔40 - 60分钟似乎是合理的。
